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Expressing milk issues and how to mixed feed

Any advice would be really helpful, thanks. She's determined to breastfeed (which of course is wonderful) but is so sad that it's been so difficult and would feel heartbroken to stop.

We haven't been able to breast feed solely, as our baby's latch is bad and he either doesn't get enough milk or has to be stopped when it's too uncomfortable.

We have ended up feeding expressed breast milk primarily, with as many added breast feeds as possible. However, my wife finds the regular failure heartbreaking - having to stop upsets our baby and she is also sad that she can't bond with him (as he immediately tries to feed and doesn't just enjoy the cuddle).

It feels as if breast feeding is controlling our lives, as it stops my wife enjoying a relaxed bond with our baby, hours are taken up with expressing and we can't go out properly, because we'd need to express constantly and transfer it to bottles.

Many thanks for any help you have....

A few things I have wondered are:

1.) How long is it possible to go without expressing (without it affecting production levels or causing issues?) My wife currently does it every 2-3 hours,as she is worried her supply will stop if she doesn't keep up. If we went out for a few hours, could we get away with just taking bottles out, and not worrying about expressing so often? (We could still do it when at home of course, but leaving the house would be very good for her happiness levels). What's a safe number of expressions each day?

2.) We have a bottle that is supposed to mimic a breast, but his latch is still very poor and seems to be worse this week. It's hard to tell if the regular bottle feeding is putting him off breast feeding - Does anyone have any experience of how you can make mixed feeding work? Breast feeding would be preferable, but it would really help to know.

3.) Does anyone have advice on how a mum can get more cuddle time with a baby, without it always being dominated by feeding?

4.) I know this is the unspeakable question, but is there ever a time when you should consider stopping breast feeding?

My wife sometimes feels that she is upsetting our baby by having to stop feeding him before he is ready. (Having to pump so often, the worry that she might be forced to give up, and barely leaving the house is also making her very unhappy). I tend to think that it's ok to try breastfeeding and fail, as long as the baby gets enough food overall?

5.) Do any of you express milk by pump when out and about (in cafes, pubs etc.)? I mean regularly (if we had to feed expressed milk in bottles as our principal way of feeding. ) We'd prefer breast feeding of course!

How do you do it? eg. under a shawl with a small pump, use a disabled toilet etc.?

Thanks again. I really want to look after my wife, as it's such an emotional issue for her and she'd love to breast feed. It's on her mind so much.

Re: Expressing milk issues and how to mixed feed

First of all, your wife is NOT failing. She is succeeding at something very, very difficult. She is providing her baby with her own milk, and if it comes in a bottle a lot of the time then so be it. Just because her success looks a little different from the way you both envisioned it does not mean that she's failing. Okay?

It is entirely normal for a baby to seek the breast whenever he is held by mom. It doesn't mean that baby thinks moms is "only for food"- it's that babies are programmed to multitask, simultaneously bonding and nursing. It can be extremely exhausting for mom, particularly when she is struggling with sore nipples, but biologically speaking it is what is supposed to be happening right now.

As to your specific questions:

1. There is no set limit for how long a mom can go without expressing/nursing. The breast's ability to store milk differs greatly between individuals. Some moms will be able to go long time periods between pumping/nursing sessions and not have that impact their supply, while others will not. I understand completely your desire to get out of the house, but right now nursing and maintaining milk supply should be your priority. If you do go out, I personally would suggest not going more than 3 hours without pumping. Doing that once should not present a problem, but doing it regularly certainly might.

2. kellymom.com has some links on paced feeding and how to bottle feed the breastfed baby which may be helpful to you.

3. Again, one shouldn't try to separate "cuddle time" and "nursing time" with such a young baby. Nursing time IS cuddle time, and the more baby nurses the better he will become at it and (hopefully) the better things will become overall.

4. A mom should discontinue breastfeeding if she has a contraindicated medical condition (HIV, active tuberculosis), or if SHE feels that the time has come to give it up. For some moms, nursing is "worth it" even if the breastmilk they provide meets only a fraction of their babies' nutritional needs. For others, breastfeeding is unendurable even if everything is going smoothly. There is no one right answer to this question. If a mom feels unable to continue to nurse, she should at least consider combination feeding; that is, some breastmilk, some formula. Combination feeding has special challenges and some drawbacks, but confers many of the same benefits as exclusive breastfeeding.

5. Pumping in public is a definite challenge. It can be done, though. Mom needs a portable electric pump, a car adapter, a shawl or poncho, a manual pump (for times when there's no power), and the willingness to pump with pride no matter where she is- in a car, in a restroom, on a plane.

Re: Expressing milk issues and how to mixed feed

Unfortunately, this is how it is at the beginning for someone who is exclusively pumping. I had to do it. My four son was born with a cleft lip and palate and was unable to nurse directly. I tried, I tried so very hard to beat the odds, but it was not to be.

But....at the beginning, pumping and feeding dominates all. It does make it hard to just bond. I also have a bunch of other kids. And what had to happen was that the necessary things got done, and anythng else was left for now. And what it meant was I pumped around the clock, fed the baby, fed the kids. Rinse and repeat. There isn't the for a lot of other things. And I do feel it makes a difference when you cannot or choose to not breastfeed in your relationship with your baby, but it is what it is, and I did not let EPing stop me from practicing my other parenting tools of cosleeping, baby wearing, not letting baby cry. There were plenty of times I held baby and fed him while pumping. There were times he wouldn't stop crying and I quit pumping so I could care for him.

This is a tough phase, as she needs to pump 120 minutes out of every 24 hours, broken into as many sessions as possible. It's not about how much milk you make. It's about time. You are making prolactin receptors that will carry you through. This is easier done if baby will nurse....so do that as much as possible! EPing actually gets harder as time goes by, so time you put in now to get baby nursing is well worth it. And this means you pump every 2-3 hours, including at least one session between midnight and 5am. Really. And this is necessary for at least the first 12 weeks. After that, I went to every 4 during the day and pumped at midnight and 5am. Did that for a while, and then I was able to move pumping around a bit. But it dominated my life, I continually thought about when and how I was going to pump, and I had to put our life on hold for a year so I could pump FT.

Pumping in public is extremely awkward. I have done it. I pumped in the middle of the Baltimore Chikdren's museum because there was nowhere else to pump. Nursing in public is much more discreet. But this wis why I did a a lot of car pumping and also why I put our life on hold. I don't have help. My husband is gone 14-16 hours a day. Pumping in public is virtually impossible without help as if the baby starts to fuss, mom is trapped by the horns. And once baby is mobile....good luck with pumping. I've managed, but probably because I stay home!

I think you guys need to exhaust all options first. And I would quit using a bottle and use any other method. I wish I had done that myself. I wish I had perservered with the SNS and trying to always finish at the breast. Then I might have had a chance post-op to nurse him, as breastfeeding is way easier in the long run.

Re: Expressing milk issues and how to mixed feed

For me...

1 - I find I get the best results expressing/pumping at three hour intervals. However I am also nursing on demand when I'm not at work. If expressing was my sole way of keeping up supply I would probably have to cut it closer to every two hours. IMO, if she's regularly at 2-3 hours and producing enough, one trip out of the house for around 3 hours probably won't destroy the supply or be too detrimental.

2 - all I can say is pace the bottles and experiment with nipples/types. Different things work for different babies. Mine actually seems to do best on a narrow/normal silicone nipple- nothing like the breast. Some babies need something very similar, some don't mind something very different and seem able to understand the difference between bottle and breast without developing a preference. As much as marketing would like to say different products are responsible for success, I really think this is more about individual preferences in the babies. Since your baby has major latch issues, maybe it's time to call another LC besides the one you've already seen for help. It's totally possible to improve things at this age

3 - This is hard at this age as the need to nurse so much. But fwiw I held my guy almost all the time. We especially enjoyed skin-to-skin contact while he was napping. It is very relaxing for mamma especially, so she might try that. She could also try a baby carrier, like a wrap or sling (I have a moby wrap and a boba structured carrier). This allows baby to cuddle close onto mom even while she's just going about her regular business (in my case, this was the only way I got the floors swept or dishes done, haha)

4 - that is different for every person. For what it's worth, my first six weeks were VERY painful. When he latched on (particularly on one side), my toes would curl and I would scrunch my entire body up in pain. I bled, cracked, etc - it was awful. I'm not particularly stubborn or committed, I didn't feel like "if I don't do this I'm a failure!!!" I just sort of stuck with it anyway - maybe it was laziness and not wanting to go out and buy formula, I don't know. And after six weeks, suddenly, miraculously, everything got better. The pain subsided, I healed, and we found our groove. A lot of women experiencing exactly the same thing might have quit - and that wouldn't necessarily be a bad thing, it just means people have different tolerance levels for pain and effort. Your wife sounds deeply, deeply committed to doing this, so I think quitting would be really heartbreaking for her. Perhaps just changing expectations - instead of worrying about nursing for 6 months or a year or two years, and worrying about failure, scale down the thinking to the current feeding or to the next day.

5 - The only time I've expressed while out is in the car. I just get myself started, cover up with a blanket, and off I go. It's slightly awkward, but otherwise not too bad. Plus, I can't sit there staring at the bottles, in angst over the amount, and stay reasonably relaxed, so I usually get a good amount that way too. I don't think I'd want to do it anywhere else unless it was a place with a nice lockable lounge area or something. Definitely no bathrooms (shudder!)

Re: Expressing milk issues and how to mixed feed

Thanks for the replies guys My husband meant to reply last night but was trying to cup feed a screaming baby! (see my other thread).

I appreciate the advice and sharing of your experiences. To be fair to my husband, he doesn't think I'm failing at all - in fact he said very similar things to Mommal's post It is really me that has the issue.

Aprilsmagic, I really admire your perseverance and what you are doing for your baby. A lot of people would have given up by now, it must take a lot to have kept going as long as you did.

Goldentoes, did you have similar issues to us - was it the latch that caused you pain? Did you have any issues like tongue tie? And do you know what finally made the difference? I am hoping Toby will suddenly realise how to latch, but at the moment he is just doing the same old thing - only opening his mouth a little bit and sucking on my nipple. I don't know if I should allow him to do this, or to keep taking him off and try to get him to do it right - any advice?

I won't write too much on here as I have updated my other thread, but I am not ready to give up yet! Regarding the pumping, we don't have a car (most people here use public transport) so it will be a challenge to pump in public -I will find a way though. As for using a sling, I do have a couple of different types - unfortunately every time I put our baby in it, he gets frustrated and tries to nurse! Which is just not possible when wearing the sling (not yet anyway!) so I have to time it well to make sure he isn't even slightly hungry.

Anyway, I am off to have some skin to skin, in the hope something might click! Thanks again for all the advice, we really appreciate it.

Re: Expressing milk issues and how to mixed feed

Looking back, my issues were most definitely latch. I was told it looked "good" at the hospital (by two of their LCs) though, and the things I was told to look for were there ("fish lips" etc). But he had a hard time getting on, and tended to slide on rather than opening wide, no matter how much I tried to take him off and correct it. I don't think there was a tongue tie issue, though I will say it took him a long time to really get to using his tongue the right way - I think for a long time he was just vacuuming. Now nursing is super easy and the main difference I see is that I can actually SEE his tongue working, as he pushes it right out with his lower lip. I don't know if he just noticed that worked better one day, or if his tongue/mouth grew, or what. I really wish I had called an LC though, probably would have saved weeks of agony.

It sounds like the issues you're having are a bit more serious than mine were - at least after about the third week I at least had one more comfortable breast to fall back on, also the pain I had usually only lasted the first few minutes of the feed, or I might have thrown myself out the nearest window.

Re: Expressing milk issues and how to mixed feed

Goldentoes, I had the same thing at the hospital and during check ups ("It looks fine") but it clearly wasn't fine as I was in constant pain! It is interesting what you say about the tongue, as this is one of our problems. I will look out to see if there is any difference as time goes by.

Aprilsmagic, 17+ months is a long time, I admire you.

I looked up rebirthing after I saw your post and it looks interesting. My husband has a day off on Tuesday so perhaps we will try it then.

I have a question about pumping and milk supply. I am aware that the first 12 weeks are crucial in establishing supply, and I should be pumping for a total of 120 minutes every 24 hours, which works out around 15 minutes, 8 times a day. If I was EP it would be easy to monitor this, but I am still breastfeeding a lot of the time, so I'm not sure if I am pumping enough, or how efficient my baby is at transferring milk. It is usually obvious if he's had a very poor feed as he either doesn't latch, or latches but doesn't drink, and in this situation I will give him expressed milk then I will pump. But sometimes he latches, drinks very well, and then his latch slips and he comes off or I take him off - so he has had kind of half a feed. Does this 'half feed' replace a pumping session, or am I meant to pump in addition? It is often difficult as he may fall asleep after a feed and I like to enjoy the cuddle

Re: Expressing milk issues and how to mixed feed

I would pump in addition, or sneak one in in between, if you are using formula at all. The idea would be to begin to replace the formula with expressed milk with the goal of having him FT at the breast.

Yes, it sucks to have to cut cuddling short. That was and is one of the hardest things for me to deal with in regards to EPing The lack of snuggle time.

Re: Expressing milk issues and how to mixed feed

Thanks He has formula very rarely but we still bottle feed him every day, so I am trying to cut down on that as much as possible. I do also try to put him to the breast most feeds, and only give him the bottle if we are unsuccessful.